LAKEPORT ? About 30 people attended a Sutter Lakeside Hospital (SLH) community forum Thursday about the hospital”s decision to become critical-access, which will require the hospital downsize its inpatient bed capacity from 69 to 25. SLH CEO Kelly Mather said it would also allow the hospital to remain stable, continue to grow its outpatient services and preserve 650 jobs.
For the money-losing hospital, critical-access will bring in federal funds that will cover the costs of four out of five Medicare patients” bills. Mather said the majority of the hospital”s patients are on Medicare. Currently, only one out of five Medicare bills are paid in full, resulting in a loss of $1 million in 2007 and a projected loss of $5 million in 2008 had the hospital decided not to become critical-access. Cost-based reimbursements for Medicare were dropped by the federal government in 2006.
An application for the designation was submitted in November followed by a Sutter Health community needs assessment that led the hospital to decide critical-access was its best option. The other three options were: do nothing and “let Sutter Health keep paying,” close the OB and ER “because they”re the money-losers” or limit services across the board, which would lead to “massive lay-offs,” Mather said.
“Our main concern is we want a stable hospital,” Mather said, reminding the audience of a period in the 1980s prior to becoming a Sutter Health hospital when the hospital had to borrow money to make payroll.
Upper Lake resident Janet Cawn, director of outreach and assistants program for the Upper Lake Senior Support Services said she doesn”t think becoming critical-access is the right solution to SLH”s money woes.
“I”m very concerned that we have a hospital investing in less important services such as yoga,” Cawn said at the end of Mather”s presentation.
Addressing patient transfers ? a main concern to many in the room and community at large ? Mather noted the average daily census has remained the same at about 25 inpatients per day since the 1970s.
In 2007, transfers numbered 360, Mather told the Record-Bee in a previous interview. Under critical-access status, that is expected to increase to about 550 transfers per year.
Speaking of critical-access and increased transfers, Cawn said she is “extremely concerned it will affect our elderly” adding a “high level of stress” that will make recovery difficult and increase hospital recidivism.
Information in a background information packet distributed to attendees at the forum said that between the 25 acute beds at Redbud Community Hospital, already a critical-access hospital, and SLH”s 25 acute beds, the beds should meet the needs of the community for “at least the next ten years.”
To officially become critical-access, the hospital needs to pass a survey by the Joint Commission this month or next, but it began operating as if it were critical-access last Friday.
“We haven”t had to turn one patient away. Actually we were [the daily census] between 16 and 13 this week because they [patients] were moved to appropriate places,” Mather said, in reference to the fact that under critical-access, patients who before would have been categorized as inpatient can actually be treated “where they need to be” ? in outpatient beds.
While the hospital is going to get about 1 percent more in Medicare reimbursement under critical-access, the extra funds cannot go to off-set other payers. And commercial payers are not going to be charged more by the hospital under critical-access, Mather said. “I would like to look into that because I would like to become more affordable,” Mather said in response to an audience question. She said, “that”s not what they [commercial payers] want to do [be off-set].”
“I would love to get insurance companies here,” Mather said. There are three reasons insurance companies do not want to come to the county, she added, including that the county “tends to be pretty ill?is remote and hard to get physicians [here]?and the general cost of care is high.”
In an answer to a question about co-payments, Mather said under critical-access, there will be a co-payment for emergency room services and a separate co-payment for inpatient services, and that it would be illegal to combine the two or waive a fee.
After the presentation, one Lakeport resident said she came to find out for herself about how the new critical-access status would affect the hospital and community after hearing “so many rumors” around town.
“I feel positive about it. It”s something we need to do. It”s better than the other options,” Mary Ann McQueen said.
Cawn said she would like to see Mather be less “mush mouthed” and give more consideration to the impacts critical-access would have on senior citizens and analyze the additional costs of transfers and how it would impact the county. County fire departments have been the main providers of ambulatory services for the past four years.
“The level of health care affects everything?we have a hard time recruiting county government officials because they cannot get affordable health care,” Cawn said.
Contact Elizabeth Wilson at ewilson@record-bee.com
